Hospital privileging: The bottlenecks you have—or the breakthrough you need

The cost of delayed hospital privileging

A provider’s frustrating wait

Let’s say a provider group hires a new orthopedic surgeon.

They have patients waiting, a fully booked surgery schedule, and a growing demand for joint replacement procedures. But before they can start, the surgeon must first be granted hospital privileges at multiple partner hospitals.

Weeks pass, then months. Paperwork is misplaced. Verifications drag on. Endless back-and-forth among administrators, insurers, and hospital committees stalls progress.

By the time privileges are finally granted, the hospital has lost valuable revenue, patients have rescheduled procedures, and frustration has spread throughout the system.

A health system’s compliance nightmare

Now, imagine a large health system bringing on a new cardiologist to expand its heart care program. The provider is highly qualified, with specialized training in advanced cardiac procedures. However, before they can step into the cath lab, the hospital must verify their credentials, training, and experience to grant privileges.

But the process stalls. Compliance teams struggle to track down primary source verifications. Hospital bylaws require multiple committee approvals, each meeting only once a month. 

Meanwhile, a critical heart patient is transferred to another facility because the cardiologist isn’t cleared to operate.

By the time privileges are granted, the hospital has lost high-value procedures, referrals have declined, and compliance risk has increased due to rushed last-minute approvals. What should be a safeguard for quality care has turned into a bottleneck that slows operations, risks patient outcomes, and disrupts revenue flow.

Hospital privileges are meant to ensure that only qualified providers deliver care within an institution. But in its current form—from a provider’s and health system’s side—hospital privileging is an inefficient, outdated process that is actively harming hospitals, patients, and providers alike.

The growing complexity of hospital privileging

The U.S. healthcare system is vast and rapidly evolving. According to a study published in the National Center for Biotechnology Information (NCBI), there are approximately 1,200 health systems in the country, covering 70% of all hospitals and 40% of all physicians.

As hospital consolidation increases, so does the complexity of provider onboarding and hospital privileging. However, workflows and processes have struggled to keep up with these changes.

The high stakes of slow hospital privileging

Every day that a provider can’t perform their services, the potential lost revenue comes out to nearly $1,901/day per provider and means:

• Lost revenue for hospitals and health systems due to unfilled procedures.
• Increased patient backlogs, leading to longer wait times and postponed care.
• Frustrated providers who remain in limbo despite being fully credentialed elsewhere.

For the orthopedic surgeon in our scenario, these delays resulted in a ripple effect—postponed surgeries, disrupted patient care plans, and inefficiencies across multiple hospital systems.

Why traditional hospital privileging processes fail

Despite its critical role, hospital privileging processes remain largely outdated. Our recent survey showed that 73% of credentialing teams say they use manual or partially manual workflows for tasks such as primary source verifications. Many still rely on paper-based applications and siloed credentialing systems, with 69% of respondents using 2-3 different tools to manage their workflows, as well.

This inefficiency leads to:

• Redundant data entry, increasing errors and missing information.
• Slow, manual verifications that create application backlogs.
• Healthcare compliance risks and hospital privileges disruption due to inconsistent documentation tracking.

Without a modern solution, these inefficiencies will only continue to delay patient care and increase administrative strain.

AI-powered hospital privileging with Medallion

Medallion has redefined provider credentialing—and now, we’ve expanded our capabilities to meet the complex demands of hospital privileging. Our enhanced solution is designed to support The Joint Commission (TJC) standards, streamline hospital applications, and accelerate approvals so providers can deliver care faster.

By integrating hospital privileging workflows directly into our credentialing platform, we help hospitals and health systems eliminate redundant processes, reduce compliance risks, and ensure providers meet regulatory standards without delays. Whether managing initial, renewal, or expansion of privileges, Medallion now offers a fully automated hospital privileging solution to keep hospitals compliant, efficient, and ready to serve patients.

Automated workflows = faster approvals

The orthopedic surgeon in our scenario could have been treating patients weeks earlier with streamlined hospital privileges. That’s exactly what Medallion offers—eliminating inefficiencies through intelligent credentialing and privileging automation:

• Real-time tracking to prevent bottlenecks and improve visibility.
• Automated primary source verification (PSV) to accelerate approvals and reduce manual errors.
• Electronic committee reviews and approvals for seamless, efficient decision-making.

Smart compliance, less risk

Speed isn’t the only challenge—compliance is equally critical. Medallion ensures that every provider meets Joint Commission, CMS, and state requirements with:

• Automated audit trails, maintaining full transparency and documentation.
• Built-in regulatory updates, ensuring hospitals always meet the latest privileging standards.
• Role-based access control, safeguarding sensitive provider data.

Transparency and real-time tracking

With Medallion, hospitals and credentialing teams gain:

• A centralized dashboard to monitor privileging status across providers.
• Automated alerts and reminders to prevent unnecessary delays.
• Seamless integration with credentialing and HR systems for a streamlined data flow.

How to complete hospital privileging in days

The orthopedic surgeon in our scenario shouldn’t have had to wait months for approval. Medallion ensures a faster, smarter hospital privileging process that benefits everyone:

Take the next step

The story of the orthopedic surgeon is just one example of how broken hospital privileging can disrupt care and hospital operations. But with Medallion, hospital privileging becomes a seamless, automated process that eliminates delays, reduces risk, and ensures providers can practice when and where they’re needed.

For more insights on effective compliance strategies, check out resources here.

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Ready to simplify your hospital privileging process? Talk with our team to get started today.